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The True Cost of SSIs

The cost of caring for patients who suffered surgical site infections after their procedures was twice as much as patients who got through surgery infection-free, according to a study in JAMA Surgery.

An analysis of more than 54,000 patients who underwent surgery in 129 Veterans Affairs hospitals in 2010 revealed approximately 1,750 suffered SSIs, 0.8% of which were considered deep infections — in tissue under the surface of the skin, organs and implants — and 2.4% were superficial infections. The average cost of caring for infected patients was $52,620, which was approximately $21,000 more than the cost of caring for patients without infections, notes the study. The relative costs for caring for infected patients was 1.43 times greater overall, 1.93 times greater for patients with deep infections and 1.25 times greater for patients with superficial infections.

Patients who experienced infections after neurosurgery were the most expensive to care for, followed by those who had orthopedic, general, peripheral vascular and urologic surgeries performed, notes the study.

The researchers note the rates of infections in VA hospitals are similar to those in private institutions as measured by the National Surgical Quality Improvement Program, and suggest surgical leaders and infection preventionists use the findings as a basis for launching quality improvement projects aimed at reducing SSI rates in their facilities, especially in light of increased scrutiny by CMS that will result in financial penalties levied against facilities that don't prevent preventable patient harm.

"Surgical site infections are not only painful to the patient, they are also costly to facilities," says the study's lead author, Marin L. Schweizer, PhD, assistant professor of internal medicine and epidemiology at the Iowa City VA Health Care System. "Interventions to reduce SSIs may be cost-effective for hospitals and ASCs."

She says the these interventions should include patient-centered precautions such as testing patients for S. aureus nasal colonization pre-operatively followed by decolonization with mupirocin or personnel interventions such as decreasing door openings in operating rooms to maintain negative airflow pressure.